The two calcineurin inhibitors routinely used for kidney transplant immunosuppression are cyclosporine (CSA) and tacrolimus (TAC). Their mechanism of action is somewhat similar (they both inhibit calcineurin, which under normal circumstances induces transcription of IL-2 in lymphocytes) but…
Another potentially useful drug to prevent cyst growth in autosomal dominant polycystic kidney disease comes from the interesting observation that kidney transplant patients with native ADPKD kidneys who were given an immunosuppressant regimen containing the drug rapamycin (sirolimus)…
Is something missing in your life? Is it the opportunity to take multiple-choice exams? If so, check out this 10-question ASN-sponsored practice test designed to prepare Nephrology Fellows to be ready for the upcoming Nephrology Boards in November….
Mycophenolic acid is a commonly encountered medication in nephrology. In addition to its use in the vast majority of kidney transplant recipients as part of the immunosuppressive regimen, it is also gaining popularity in the treatment of immune-mediated…
A relatively new immunosuppressant agent–originally approved for treatment of refractory rheumatoid arthritis but now gaining steam as an anti-rejection medication for kidney transplant recipients–is abatacept (marketed under the trade name Orencia by Bristol-Myers-Squibb. Its mechanism of action is…
I’m reporting LIVE from the American Society of Nephrology convention in Philadelphia, PA. I’ll be blogging from here as time & internet connectivity permit. The conference starts in earnest tomorrow morning. Until then: common drug interactions for TACROLIMUS…
Cyclosporin A (CsA) has been a mainstay of therapy for nephrologists: it (along with tacrolimus) has become the cornerstone of immunosuppressant therapy for kidney transplant patients; in addition, it has also seen use as an effective agent in…
Welcome to Cytoxan (cyclophosphamide), one of the most versatile (albeit toxic) medications in the nephrology world. Its mechanism of action is as an alkylating agent; it induced alkylation of DNA in actively proliferating cells, which explains its use…
When one is just beginning as a nephrology fellow, it may seem as if all the major glomerular diseases (e.g., membranous nephropathy, FSGS, lupus, etc) are all treated with the same protocols and same immunosuppressive agents: steroids, Cytoxan,…
Did you know that diarrhea increases the absorption of Prograf (tacrolimus, FK506)? Drug levels must be monitored closely in this setting to avoid tacrolimus-induced allograft toxicity. Tacrolimus is even considered a cause of diarrhea by some, though its…
